US5843188A - Accommodative lens implantation - Google Patents
Accommodative lens implantation Download PDFInfo
- Publication number
- US5843188A US5843188A US08/954,656 US95465697A US5843188A US 5843188 A US5843188 A US 5843188A US 95465697 A US95465697 A US 95465697A US 5843188 A US5843188 A US 5843188A
- Authority
- US
- United States
- Prior art keywords
- lens
- haptics
- eye
- zone
- artificial lens
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Expired - Fee Related
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Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/14—Eye parts, e.g. lenses, corneal implants; Implanting instruments specially adapted therefor; Artificial eyes
- A61F2/16—Intraocular lenses
- A61F2/1613—Intraocular lenses having special lens configurations, e.g. multipart lenses; having particular optical properties, e.g. pseudo-accommodative lenses, lenses having aberration corrections, diffractive lenses, lenses for variably absorbing electromagnetic radiation, lenses having variable focus
- A61F2/1624—Intraocular lenses having special lens configurations, e.g. multipart lenses; having particular optical properties, e.g. pseudo-accommodative lenses, lenses having aberration corrections, diffractive lenses, lenses for variably absorbing electromagnetic radiation, lenses having variable focus having adjustable focus; power activated variable focus means, e.g. mechanically or electrically by the ciliary muscle or from the outside
- A61F2/1629—Intraocular lenses having special lens configurations, e.g. multipart lenses; having particular optical properties, e.g. pseudo-accommodative lenses, lenses having aberration corrections, diffractive lenses, lenses for variably absorbing electromagnetic radiation, lenses having variable focus having adjustable focus; power activated variable focus means, e.g. mechanically or electrically by the ciliary muscle or from the outside for changing longitudinal position, i.e. along the visual axis when implanted
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/14—Eye parts, e.g. lenses, corneal implants; Implanting instruments specially adapted therefor; Artificial eyes
- A61F2/16—Intraocular lenses
- A61F2/1602—Corrective lenses for use in addition to the natural lenses of the eyes or for pseudo-phakic eyes
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/14—Eye parts, e.g. lenses, corneal implants; Implanting instruments specially adapted therefor; Artificial eyes
- A61F2/16—Intraocular lenses
- A61F2/1602—Corrective lenses for use in addition to the natural lenses of the eyes or for pseudo-phakic eyes
- A61F2/161—Posterior chamber lenses for use in addition to the natural lenses of the eyes
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/14—Eye parts, e.g. lenses, corneal implants; Implanting instruments specially adapted therefor; Artificial eyes
- A61F2/16—Intraocular lenses
- A61F2/1601—Lens body having features to facilitate aqueous fluid flow across the intraocular lens, e.g. for pressure equalization or nutrient delivery
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/14—Eye parts, e.g. lenses, corneal implants; Implanting instruments specially adapted therefor; Artificial eyes
- A61F2/16—Intraocular lenses
- A61F2002/1681—Intraocular lenses having supporting structure for lens, e.g. haptics
- A61F2002/1689—Intraocular lenses having supporting structure for lens, e.g. haptics having plate-haptics
Definitions
- This invention relates generally to implantation of artificial lenses in the eyes of humans, and/or animals, and more particularly concerns implantation of such lenses in the posterior chambers of the eyes, i.e., between the iris and the natural lens zone. That zone may contain a natural lens, or an artificial lens, such as a pseudophakic lens.
- the method of the invention includes the steps:
- the artificial lens to be compliant and to have anterior and posterior surfaces, and haptics extending away from the periphery of the artificial lens
- Such adherence may be achieved by adherence of haptic outer surfaces to zonular ligaments and/or onto fascia of the ciliary muscles, thereby positioning the artificial lens close to the surface of the pseudophakic lens; and so that clarity of vision is not interrupted by bonding zones, or clip devices to hold the lens in place, such bonding and clips not being needed.
- b) allows placement of an elongated, asymmetric lens implant across the eye chamber to position the haptics for fixation onto zonular ligaments and/or into the fascia of the ciliary muscle;
- c) affords conforming of a lens implant posterior surface over the pseudophakic lens, with haptics that extend laterally to anchor onto the available plateau at the ciliary sulcus, the fascia of the ciliary muscle, and/or onto the inert zonular ligaments;
- f provides an axis of astigmatism, and prisms, or other means, for correcting diplopia with particular haptic edge designs
- g provides separability of the implanted lens from the pseudophakic lens, to:
- h provides for more natural passage of aqueous humor between the pseudophakic and implanted lenses; accommodation of the lens implant is enhanced by conformance to the natural lens configuration that exists, particularly in the realm of the autonomic nerve system, and pertaining to accommodative reflex;
- components for the errancy of the pseudophakic lens needs such as light-blocking function of the lens implant for glare and U-V exposure, in addition to refractive corrections for astigmatism, diplopia, anisometropia, and for severe and mild degrees of myopia and hyperopia, and loss of accommodation;
- the range of useful indications for this lens implant are startling and may require or enable a combination of seven to eight different lens implants in one lens implant procedure, to achieve a desired vision result;
- the ciliary muscle having a leveraged effect on the optic segment through the angle of approach of the lateral and posterior design and stiffening of the haptic, as well as adhesive, restraint on the optic segment to prevent excessive forward advancement of the optic segment by the addition of adhesive haptic edges, which also thickens the A-P diameter of the lens to assist in accommodation.
- a further object includes detecting and modifying a physical characteristic of the lens inserted into the eye.
- Miniature electronic circuitry implants on the lens unit, as via a wafer or wafers, may be employed in such determination, and/or modification.
- FIG. 1 is a cross section through the eye showing lens unit implantation
- FIG. 2 is a plan view of an artificial lens incorporating the features of FIG. 1.
- FIG. 3 is a plan view of a modified artificial lens.
- FIG. 4 is a plan view of a further modified artificial lens having an external master control.
- FIG. 5 is an enlarged fragmentary view of a lens unit haptic with electronic circuitry thereon.
- FIG. 6 is a schematic circuit diagram.
- the artificial lens unit 10 has been implanted into the eye 11 between the iris 12 and the natural lens zone 13. That zone is shown as including a capsule 90 from which the natural lens has been removed, and a pseudophakic (initially inserted) artificial lens 14 inserted in the capsule.
- the purpose for inserting lens unit 10 is to improve vision, as by correcting for vision defect associated with artificial lens 14 alone. Eye ciliary muscles are indicated at 15; and they surround the capsule to which they are peripherally attached, as at 15a. The pupil appears at 16. Posterior and anterior eye zones appear at 17 and 18.
- a wound 19 in the pupil affords entry of the folded artificial lens unit 10 into the zone 18, from which it is maneuvered into zone 17, to the position shown. Haptics 21 do not engage the iris.
- Lens unit 10 which may consist of silicone or equivalent material, has haptics 21, which extend oppositely away from the bead-like lens 22 in front of lens 14. See FIG. 1, for example.
- the haptics are or become attached or adhered to the forward-facing sides of the ciliary muscles, as at 15b, which provide a platform for haptic attachment.
- the tabular haptics may have roughened surface extents, to face and engage the ciliary muscles, promoting adherence, as via eye tissue growth.
- One preferred example of such roughened surface extent is the mesh indicated at 25 in FIG. 2.
- the haptics have sufficient stiffness to move laterally (see arrows 30) with the ciliary muscles, whose movement controls lateral contraction of the capsule, such lateral movement of the haptics being transmitted to the bulging lens bead 22, to effect its axial longitudinal deflection in the direction of arrows 33.
- Such deflection is sufficient to cause the lens 22 to refract light rays from an observed object to again focus at a point near the wearer's retina.
- lens deflection to obtain proper focusing is made possible by the initial angularity of the haptics, by the stiffness along their lateral extents, and by haptics effective hinging connection to the lens 22, along the bendable, lateral extents of the haptics, between 22 and 21. See FIG. 2.
- the gap contains eye fluid to wet the lenses; and a port or ports 91 may be provided in the haptics to allow eye fluid flow in and out of the gap 35, as before, during, or after lens 22 bodily movement, as described.
- the haptics may have yieldably flexible outer tips 40 to engage the inner wall 41 of zone 17, to aid in centering the lens unit 10, relative to the lens 14, and to aid in stably positioning the haptic roughened surface portions 25 adjacent the ciliary muscles, during adherence as by tissue growth.
- the haptics are allowed to adhere to the ciliary muscles so as to maintain the gap 35 between a medial portion of the artificial lens and the natural lens, or its zone; also the artificial lens and haptics are maintained out of contact with the iris, as shown in FIG. 1.
- FIG. 3 shows an elongated lens unit 50 having an elongated, asymmetric, light-transmitting, medial lens portion 51, haptics 52 with roughened or mesh-like regions 53, for adherence to ciliary muscles, and eye fluid passing through ports 54.
- Haptics positioning tips appear at 56, and may be used, as ae tips 40.
- FIGS. 4-6 show a unique means to operatively associate electronic or electrical circuitry with the implantable lens unit.
- the lens unit may have a configuration the same as in FIG. 2, for example. See the same identifying numerals applied.
- electrical circuitry indicated generally at 60, as in or on a wafer 60a attached as by bonding to the lens unit, as at haptics 21. Note the local and symmetrical locations of four such wafers 60a.
- An external, master control unit 62 may have electrical or magnetic communication with the circuitry on the four wafers. See four paths or connectors 62a.
- Microelectronic circuitry may be provided on the wafers to process data or signals.
- FIG. 5 shows a circuit element 61, such as a resistor.
- FIG. 6 shows a current source in series with the element 61, the source for example including a coil 61a and a diode 61b. A magnetic field passing through the coil generate current, rectified at 61b and passing through the resistor.
- An external coil 63 and AC generator 64 generates the magnetic field. See also circuitry 66.
- the circuitry can be embedded in the wafer and located in or on the haptic.
- One example of use is to detect strain, due to deflection in the haptic.
- the resistor 61 effectively bonded to the haptic, as via the wafer, is stretched as the haptic deflects, changing its resistance. This changes the response to the circuitry, reflected back through coils 61a and 63 and detected at 66, whereby the amount of deflection of the haptic can be determined externally.
- the use of four such detectors, as at 60a in FIG. 4, and on both haptics, enables accurate determination of inserted lens responsive movement, as the eye ciliary muscles expand and contract.
- Such lens movement can then be modified, i.e., "tuned” to conform to a predetermined standard, externally. See for example the lens haptic zones 70 near each wafer, and which can be deformed as by a laser beam 71, to modify local thickness or shape of the haptic, thereby slightly changing its characteristic movement.
- Zones 70 may, for example, consist of thermo-plastic material, subject to shape change, with temperature increase above a temperature threshold. In this way, accuracy of vision, provided by the lens insert, can be optimized.
- Other types of circuits 60, and uses thereof, are of course possible and are within the scope of this invention, directed to provision of microcircuitry on an implanted lens unit.
- the invention enables testing for the optimum lens insert, as for example by the steps:
- Other existing lens can be a pseudophakic lens, or a lens, such as a natural lens of the eye.
- Light-blocking darkened or qpaque zones may be provided on or at or proximate the lens periphery, as for example are indicated at 80 in FIG. 2.
- Sensors embedded in the elastomide (synthetic resin) of the lens unit will detect activity, such as movement of the ciliary muscle, to which the haptic becomes attached, as described.
- activity such as movement of the ciliary muscle, to which the haptic becomes attached, as described.
- ciliary muscle contraction as detected at the multiple points (four as described) of circuit sensor location, is detected, as the lens optic is advanced forwardly, by accommodation, and the reverse occurs when the optic retracts as the ciliary muscle relaxes.
- Such sensors can be used to detect rotation of the toric lens. Also, maintenance of immobility of the lens unit and ciliary muscle, as desired during healing, i.e., adhesion attachment of the haptics to the ciliary muscle, can be monitored using such sensors. Local control of lens darkening, using such circuitry with circuit flow between selected points on the lens unit to effect such selected zone darkening is also contemplated.
Abstract
Description
Claims (31)
Priority Applications (2)
Application Number | Priority Date | Filing Date | Title |
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US08/954,656 US5843188A (en) | 1997-10-20 | 1997-10-20 | Accommodative lens implantation |
US09/198,254 US6096078A (en) | 1997-10-20 | 1998-11-24 | Accommodative lens implantation |
Applications Claiming Priority (1)
Application Number | Priority Date | Filing Date | Title |
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US08/954,656 US5843188A (en) | 1997-10-20 | 1997-10-20 | Accommodative lens implantation |
Related Child Applications (1)
Application Number | Title | Priority Date | Filing Date |
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US09/198,254 Continuation US6096078A (en) | 1997-10-20 | 1998-11-24 | Accommodative lens implantation |
Publications (1)
Publication Number | Publication Date |
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US5843188A true US5843188A (en) | 1998-12-01 |
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ID=25495755
Family Applications (2)
Application Number | Title | Priority Date | Filing Date |
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US08/954,656 Expired - Fee Related US5843188A (en) | 1997-10-20 | 1997-10-20 | Accommodative lens implantation |
US09/198,254 Expired - Fee Related US6096078A (en) | 1997-10-20 | 1998-11-24 | Accommodative lens implantation |
Family Applications After (1)
Application Number | Title | Priority Date | Filing Date |
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US09/198,254 Expired - Fee Related US6096078A (en) | 1997-10-20 | 1998-11-24 | Accommodative lens implantation |
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US (2) | US5843188A (en) |
Cited By (94)
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US6051024A (en) * | 1995-10-06 | 2000-04-18 | Cumming; J. Stuart | Intraocular lenses with fixated haptics |
WO2000027315A1 (en) * | 1998-11-10 | 2000-05-18 | Allergan Sales, Inc. | Accommodating multifocal intraocular lens |
WO2001008606A1 (en) * | 1999-08-02 | 2001-02-08 | Ioltechnologie-Production | Intraocular implant for crystalline lens |
US6200342B1 (en) | 1999-05-11 | 2001-03-13 | Marie-Jose B. Tassignon | Intraocular lens with accommodative properties |
WO2001019288A1 (en) * | 1999-09-17 | 2001-03-22 | Allergan Sales, Inc. | Intraocular lens with surrounded lens zone |
US6406494B1 (en) | 1999-04-30 | 2002-06-18 | Allergan Sales, Inc. | Moveable intraocular lens |
US6488708B2 (en) | 1999-04-09 | 2002-12-03 | Faezeh Sarfarazi | Open chamber, elliptical, accommodative intraocular lens system |
WO2003015669A1 (en) * | 2001-08-21 | 2003-02-27 | Nulens Ltd. | Accommodating lens assembly |
US6551354B1 (en) | 2000-03-09 | 2003-04-22 | Advanced Medical Optics, Inc. | Accommodating intraocular lens |
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US6599317B1 (en) | 1999-09-17 | 2003-07-29 | Advanced Medical Optics, Inc. | Intraocular lens with a translational zone |
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US6638305B2 (en) | 2001-05-15 | 2003-10-28 | Advanced Medical Optics, Inc. | Monofocal intraocular lens convertible to multifocal intraocular lens |
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